BackgroundThe traditional g.so-ba-rig-pa hospitals in Bhutan uses more than 100 polyingredient medicines that are manufactured by the Menjong Sorig Pharmaceuticals (MSP). The MSP has been collecting medicinal plants from Lingzhi region for about 48 years and therefore the ecological pressure on these plants have increased. It is MSP’s top priority to identify an alternative collection site to ease the problem. Therefore, this study was carried out to determine whether Dagala region could potentially be an alternative collection site for MSP.MethodsFirst the multidisciplinary research team generated a tentative plant list by reviewing a body of ancient g.so-ba-rig-pa literature, current formulations, and the MSP medicinal plants inventory documents. Second, the research team visited the study areas in Dagala region for spot identification of medicinal plants. Third, we confirmed our traditional and botanical identification by crosschecking the descriptions with the series of books on traditional texts, Flora of Bhutan, scientific papers on medicinal plants, and the plant databases.ResultsWe have identified 100 species of high altitude medicinal plants from Dagala region. Of these, 24 species grow abundantly, 29 species grow in moderate numbers and 47 species were scarce. More than 85 species belonged to the herbaceous life form and 51 of them are used as a whole plant. A total of 68 species grow in between 4000 and 4999 meter above sea level. These 100 medicinal plants represented 39 different families and 80 genera and the maximum number of plants belonged to the family Asteraceae. Of 60 species that are currently used for formulating medicines at MSP, 16 species have economic importance with potential for commercial collection. Out of seven areas covered by the survey, Kipchen hosted maximum number of medicinal plants (21 species).ConclusionsOur survey identified 100 medicinal plants from Dagala region and of these, 16 species has economic potential that could benefit both MSP and Dagala communities. It is feasible to establish an alternative medicinal plants collection center in Dagala Gewog.

The Tibetan plateau of China is one of the world's major pastoral areas, in which rangeland management underwent fundamental changes in the twentieth century. This article reviews the rangeland privatisation process in the Tibetan plateau over the last ten years, examining cases from

Abstract. This paper aims to identify a survival curve involving risk factors for cardiovascular diseases patients in Bhutan. There are 5,206 cardiovascular diseases patients recorded in Jigme Dorji Wangchuck National Referral Hospital (JDWNRH) medical record department as of January 2006 to December 2016. In addition, it examines a relationship between survival time and some risk factors by using univariate and multivariate Cox's proportional hazard models. Application of Log-rank test and Cox's proportional hazard model compares the survival curves and find the covariates that affects the survival time. The results showed that, during the follow up a total of 844 (16.2%) CVD patients died which 216 (13.3%) was young-aged, 201 (13.7%) a middle-aged and 427 (20.2%) an old-aged. The survivorship curves are plotted using Kaplan Meier method and identified some risk factors using univariate and multivariate Cox's model. The risk factors were identified as, namely, age, sex, frequency of hospital visits, CVD subtype, number of diagnosis, ward, hypertension, diabetes, myocardial infarction, and cerebral infarction. Further, risk factors for each age group are illustrated at the significant p-value <0.05. IntroductionCardiovascular Diseases (CVDs) are the number one cause of death globally and to the less economically developed country like Bhutan. Every year, more number of people die of cardiovascular disease than from any other cause. Cardiovascular Disease (CVD) is the condition that affects the functioning of heart organ and flow of blood in the circulatory system [1]. The competitive risk factors like diabetes, obesity, and the metabolic syndrome contributes to the ascending trend of CVD patients and its mortality. Thus, in the face of public health and individual's economy, it is a huge burden requiring a renewed approach towards prevention of risk factors [2][3][4].Survival models in finding risk factors for cardiovascular patients would be effective in lengthening mortality, treatment and lifestyle modification for CVD patients [5][6][7]. Various studies conducted to frame a risk factors model for short and long terms risk [8]. The association between CVD sub-types and age groups are significant [9][10][11]. Kaplan Meier and Cox's models have widely used to study the relation between CVD's patients and associated risk factors [12][13][14].The aim of this study is to compare the survival function for each age group within covariates and examine the relationship between survival time and risk factors by Cox's proportional hazard models.

Climate change has been a global threat, however, promoting awareness of climate change will reduce its risk. The study analyzed awareness on three aspects of climate change—causes, impacts, and mitigation among 90 teachers from three high schools, selected using stratified random sampling. We identified a total of 15 statements or variables from each of the causes, impacts, and mitigation to study the teacher’s awareness of climate change. We found that teachers have a medium level of awareness, being more aware of impacts than causes and mitigation of climate change. Three factors– teaching field, education level, and seminar attendance have significantly influenced the teachers’ awareness level on climate change. The result suggests that upgrading education, incorporating environmental studies in educational curriculum, and promoting seminar and workshop on environmental issues increases awareness on climate change.

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